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J Neurovirol. 2019 Feb;25(1):57-71. doi: 10.1007/s13365-018-0686-5. Epub 2018 Nov 9.

Enhanced facilitation and diminished inhibition characterizes the pronociceptive endogenous pain modulatory balance of persons living with HIV and chronic pain.

Author information

1
Department of Psychology, University of Alabama at Birmingham, 1300 University Boulevard, Campbell Hall, Room 237, Birmingham, AL, 35294, USA.
2
Department of Anesthesia & Perioperative Medicine, University of Cape Town, Cape Town, South Africa.
3
Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA.
4
Divisions of General Internal Medicine and Infectious Diseases, University of Pittsburgh, Pittsburgh, PA, USA.
5
Department of Psychology, University of Alabama at Birmingham, 1300 University Boulevard, Campbell Hall, Room 237, Birmingham, AL, 35294, USA. bgoodin1@uab.edu.
6
Department of Anesthesiology & Perioperative Medicine, Division of Pain Medicine, University of Alabama at Birmingham, Birmingham, AL, USA. bgoodin1@uab.edu.

Abstract

Chronic pain in persons living with HIV (PLWH) may be related to alterations in endogenous pain modulatory processes (e.g., high facilitation and low inhibition of nociception) that promote exaggerated pain responses, known as hyperalgesia, and central nervous system (CNS) sensitization. This observational study examined differences in endogenous pain modulatory processes between 59 PLWH with chronic pain, 51 PLWH without chronic pain, and 50 controls without HIV or chronic pain. Quantitative sensory testing for temporal summation (TS) of mechanical and heat pain as well as conditioned pain modulation (CPM) were used to assess endogenous pain facilitatory and inhibitory processes, respectively. Associations among TS, CPM, and self-reported clinical pain severity were also examined in PLWH with chronic pain. Findings demonstrated significantly greater TS of mechanical and heat pain for PLWH with chronic pain compared to PLWH without chronic pain and controls. CPM effects were present in controls, but not in either PLWH with or without chronic pain. Among PLWH with chronic pain, greater TS of mechanical pain was significantly associated with greater average clinical pain severity. Results of this study suggest that enhanced facilitation and diminished inhibition characterizes the pronociceptive endogenous pain modulatory balance of persons living with HIV and chronic pain.

KEYWORDS:

Chronic pain; Conditioned pain modulation; Endogenous pain modulation; HIV; Temporal summation

PMID:
30414048
PMCID:
PMC6446934
[Available on 2020-02-01]
DOI:
10.1007/s13365-018-0686-5

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